Streamlining the ICD-10 testing methodology

Payers are gearing up for the testing phase of ICD-10, one which is bound to be cumbersome and a long process. There are numerous partners involved in the process, and working with various providers and clearinghouses ensuring they accept the codes, will require adequate testing procedures to be put in place.

ICD-10 testing process by far will be a more of a qualitative process rather than a quantitative one. The factors of prime importance will be the selection of test scenarios, data and validation processes. We have listed these different areas of testing which will make your ICD-10 implementation a success.

Internal ICD-10 testing

Integration Testing: This is the first stage of testing which needs to be executed. In this stage, each individual module which has been modified to incorporate the ICD-10 codes is integrated back into the system and the flow of data is verified by our team. This will show any component which needs to be re-coded for ICD-10 codes, optimize workflow and ensure that all components are integrated back into the system.

End-to-end Testing: In this stage, we validate all the internal and external ports, hence validating the different possible data outputs for ICD-10 codes. Here we ensure that the entire system is functioning as intended with the changes implemented.

External ICD-10 testing

Provider Testing: Here we select different providers of varying sizes, and opt for mixed transaction types. We identify different test scenarios which work for different providers, and validate the system for historic and recently input data with ICD-10 codes.

Clearinghouse Testing: The primary objective of this kind of testing is to ensure that the clearinghouse transactions are validated against the set system guidelines. This is one of the most important steps for ICD-10 readiness, ensuring accurate and timely payments are received as per prevalent ICD-10 codes.

Payer Testing: Payer-to-payer testing helps to confirm that the information received is transmitted and accepted by the receiving organization, enabling complex calculations and payments to all involved payers.

One of the best practices followed with regard to ICD-10 testing is the involvement of different vendors who are specialized in different areas of this testing methodology. Each qualified vendor involved in this process, contributes to the readiness and validation of this testing process. This distributed testing process also enables quick turnaround and adds to visibility.